Department of Haematology, The First Affiliated Hospital of Sun Yat-sen University, No.58 Zhongshan 2nd Road, Guangzhou, 510080, China.
J Health Popul Nutr. 2023 Oct 2;42(1):105. doi: 10.1186/s41043-023-00429-8.
A virus infection may lead the body to produce more immune cells of particular types or stimulate the production of new ones, both of which may have anti-leukemic effects. There has been no research on whether immune cells stimulated by varicella-zoster virus (VZV) infection have anti-leukemic effects. The objective of this investigation is to assess the impact of VZV infection on patients' long-term survival following allogeneic hematopoietic stem cell transplantation (allo-HSCT).
This retrospective study investigated the association between varicella-zoster virus (VZV) reactivation and outcomes in 219 individuals who received allogeneic hematopoietic stem cell transplantation (allo-HSCT) at the Sun Yat-sen University's First Affiliated Hospital. According to being diagnosed with VZV infection or not, these patients were grouped into two groups. The comparison of cumulative incidence of relapse, non-recurrent mortality, and overall survival (OS) was conducted between the two groups.
Analyzing multivariate data, VZV reactivation was linked to lower relapse incidence in the group containing all individuals (hazard ratio [HR] = 0.27; 95% confidence interval [CI], 0.12-0.64), patients suffering from acute myeloid leukaemia (HR = 0.10; 95% CI, 0.01-0.83), and patients suffering from acute lymphoblastic leukaemia (HR = 0.25; 95% CI, 0.08-0.77). Moreover, VZV reactivation was linked with decreased non-relapse mortality in all individuals (HR = 0.20; 95% CI, 0.05-0.79), but no statistical significance was found for any disease subgroup. Further, VZV reactivation was an independent predictor for improved OS in the group containing all individuals (HR = 0.10; 95% CI, 0.03-0.29), patients suffering from acute myeloid leukaemia (HR = 0.09; 95% CI, 0.01-0.66), and patients suffering from acute lymphoblastic leukaemia (HR = 0.16; 95% CI, 0.04-0.68).
This is the first study to show that VZV reactivation following allo-HSCT is an independent predictor for lower relapse rates and improved OS, providing novel therapeutic approaches to improve patients' long-term survival following allo-HSCT.
病毒感染可能导致机体产生更多特定类型的免疫细胞或刺激新免疫细胞的产生，这两者都可能具有抗白血病作用。目前尚未有研究探讨水痘带状疱疹病毒（VZV）感染所刺激产生的免疫细胞是否具有抗白血病作用。本研究旨在评估 VZV 感染对异基因造血干细胞移植（allo-HSCT）后患者长期生存的影响。
本回顾性研究调查了中山大学第一附属医院 219 例接受异基因造血干细胞移植（allo-HSCT）患者的 VZV 再激活与结局之间的关系。根据是否诊断为 VZV 感染，将这些患者分为两组。比较两组的累积复发率、非复发死亡率和总生存率（OS）。
多变量数据分析显示，VZV 再激活与所有患者（风险比[HR] = 0.27；95%置信区间[CI]，0.12-0.64）、急性髓系白血病（HR = 0.10；95%CI，0.01-0.83）和急性淋巴细胞白血病（HR = 0.25；95%CI，0.08-0.77）患者复发率降低相关。此外，VZV 再激活与所有患者的非复发死亡率降低相关（HR = 0.20；95%CI，0.05-0.79），但在任何疾病亚组中均无统计学意义。进一步的研究发现，VZV 再激活是所有患者（HR = 0.10；95%CI，0.03-0.29）、急性髓系白血病（HR = 0.09；95%CI，0.01-0.66）和急性淋巴细胞白血病（HR = 0.16；95%CI，0.04-0.68）患者 OS 改善的独立预测因素。
这是第一项表明 allo-HSCT 后 VZV 再激活是降低复发率和改善 OS 的独立预测因素的研究，为改善 allo-HSCT 后患者的长期生存提供了新的治疗方法。
